Buprenorphine Prescriptions are “Disappointingly Low”

Posted on March 17, 2014 at 8:04 pm

Unfortunately, only few family doctors that have completed the required training to prescribe buprenorphine for opioid-addicted patients actually do.[1] In fact, a study conducted by researchers at the University of Washington in Seattle found that following training completion, fewer than one-third of physicians report prescribing buprenorphine to treat addiction.1

Study investigator Roger A. Rosenblatt, MD, MPH, of the Department of Family Medicine at the University of Washington said, “It’s actually quite frustrating because the problem of opioid addiction has grown enormously in the US over the last 15 years, to the extent that unintentional lethal overdoses from opioids now exceed the number of deaths from car accidents.”1

The Drug Addiction Treatment Act was passed in 2000, allowing qualified and trained physicians to prescribe buprenorphine for opioid addiction.1

“Prior to that, patients had to go to a methadone maintenance clinic, which are not available to a large part of the population, are extremely onerous, and all have long waiting lists,” said Rosenblatt, “The hope was that physicians would begin to prescribe buprenorphine just like we prescribe medication for other chronic diseases like diabetes.”1

However, according to a survey of 78 physicians who are trained to prescribe buprenorphine, in the seven to 18 months after completing their training, all reported positive attitudes toward buprenorphine, but only 22 reported prescribing the drug.1

“Although the majority passed the test and got the waiver, only 28 percent said they were actually using buprenorphine for addiction in their practices—a disappointingly low number,” said Rosenblatt. “Physicians tell us that just being able to prescribe it alone isn’t enough. They feel like they need more access to mental health counselors, preferably embedded in the practice. They need to have other partners in their practice who can prescribe it and access to specialists who they can call on.”1

Chair of the American Psychiatric Association (APA) Council on Addiction Psychiatry, Frances R. Levin, agrees with physicians.1

“The greatest limitation for the family practice doctors is providing mental health and psychosocial support, to address psychological distress that may undermine recovery and to offer evidence-based therapies for relapse prevention,” Levin said. “Psychiatrists can provide this mental health aspect of addiction treatment, which should make it somewhat easier for them to work successfully with patients on buprenorphine. On the other hand, other factors such as lack of confidence or time constraints in a private practice setting may be a barrier for psychiatrists and family practice doctors alike.”1

Rosenblatt and Levin believe that moving towards a collaborative environment for practitioners will help the number of prescribers rise.1

“Individual collaborations between practitioners can be very effective, so that a primary care physician can refer a patient with comorbid [opioid use], mood, or anxiety issues to a psychiatrist before initiating buprenorphine treatment.”1